Individual
JENAIYA AELIN ELLIS DELAVEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
348 N BLUFF ST STE 104, SAINT GEORGE, UT 84770-5523
(360) 631-7567
Mailing address
514 S 1990 E APT 520, ST GEORGE, UT 84790-5086
(360) 631-7567
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13591986-4701
UT
225700000X
Massage Therapist
MA61479402
WA
Other
Enumeration date
08/30/2023
Last updated
07/29/2024
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